New Pacemaker Is Roughly The Size Of A Vitamin

Computers aren’t the only shrinking technology — medical devices are getting smaller and less invasive too. A Minneapolis company called Medtronic has recently announced the successful implant of its new pacemaker, the smallest version of the device in the world.

Their pacemaker, the Micra Transcatheter Pacing System, was implanted in an Austrian patient during a global clinical trial. It’s about a tenth of the size of typical pacemaker, and its installation is far less invasive than with conventional pacemakers, which require a surgical chest incision. For the Micra TPS, doctors implant the device by sending it inside a catheter into the femoral vein, a major vein connecting the leg to the heart. Once in position, the pacemaker attaches to the wall of the heart, though it can be repositioned manually if necessary. It doesn’t use wires or leads to connect to the heart, but instead delivers electrical impulses via an electrode.

The pacemaker improves upon a 2011 leadless pacemaker breakthrough by Nanostim, a company that had previously designed a smaller pacemaker (Medtronic’s is 30% smaller) with a similar implantation procedure. But Medtronic seems to have improved on that model, not only with the smaller size but also with its battery, which lasts for 10 years. These advances in pacemaker technology should eliminate some of the complications that arise with traditional pacemakers and their surgical implantation, which will lead to a faster recovery for patients. Patients also won’t have the usual detectable lump under their skin or scars from the chest incisions.

EBR Systems has also been working on a wireless, lead zirconate titanate pacemaker, though theirs uses ultrasound waves to activate it, and then the pacemaker converts acoustic energy into electricity via a transducer and an electrode receiver. It’s also the first pacemaker able to be implanted in the left side of the heart. All of these new pacemakers eliminate wires, which have been a source of pacemaker problems.

Medtronic’s clinical trial will include just under 800 patients at 50 centers around the world, with Austria being the first, and initial results and follow-up data will be released in mid to late 2014. One aspect that hasn’t been addressed in the literature I’ve read is whether these innovations in wireless pacemaker technology decrease, or affect in any way, the pacemakers’ susceptibility to hacking.

Ever since the season 2 Homeland episode in which Nicholas Brody remotely hacks the vice president’s pacemaker and kills him, the possibilities of pacemaker hacking have received lots of attention. Even Dick Cheney admitted to alterations in his own pacemaker, namely by turning off its wireless, after worrying that he could suffer the same fate. There’s also the curious case of Barnaby Jack, professional hacker who died just before revealing what he promised would be critical information about hacking pacemakers. Whatever happens with this technology, it will be, of course, shocking (sorry!).